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Revista Cubana de Medicina
Article . 1996
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Elementos de predicción en la nefropatía por inmunoglobulina A

Authors: Orestes Benítez Llanes; Juan Alberto Henrry Pavier; Juan Castañer Moreno; Jorge Fuentes Abreu;

Elementos de predicción en la nefropatía por inmunoglobulina A

Abstract

Se realizó un análisis clinicopatológico de todas las biopsias renales efectuadas entre octubre de 1988 y mayo de 1993, donde se demostró la presencia de nefropatía por inmunoglobulina A (NIgA), para conocer su incidencia en nuestro medio e identificar, por sus manifestaciones clínicas, sus posibles indicadores pronósticos. Con excepción de las enfermedades sistémicas (por funcionar un grupo de estudio multidisciplinario en nuestra Institución), la indicación más frecuente para realizar una biopsia renal fue la presencia de alteraciones del sedimento urinario (57/161; 35,4 %), principalmente hematuria (38/161; 23,6 %). El diagnóstico histológico fue realizado en 51 (89,4 %) de 57 pacientes con alteraciones del sedimento urinario, 14 (30,4 %) tenían NIgA, otro presentó un cuadro de nefritis aguda y azotemia que no requirió de tratamiento dialítico, posteriormente mantuvo cuadro de hematuria microscópica persistente. La NIgA representó el 9,3 % (15/161) del total de biopsias realiza-das y el 17 % (15/88) de las enfermedades glomerulares primarias. Se evaluaron los hallazgos clinicohistológicos y las modificaciones de la función renal en los 15 pacientes con NIgA, 14 de los cuales tenían un aclaramiento de creatinina mayor de 70 mL/min en el momento de la biopsia renal. Se concluye que la presencia de hipertensión arterial, proteinuria y patrón histológico de proliferación mesangial difusa representan un mal pronóstico en la evolución de esta enfermedad.A clinical and pathological analysis of all renal biopsies performed between October, 1988 and May, 1993, was made and the presence of IgA nephropathy was evidenced. The objective of this study was to know the incidence of the disease in our environment and identify possible prognostic indicators by clinical manifestations. With the exception of systemic diseases (since there is a multidisciplinary study group in our institution), the most frequent indication for a renal biopsy was the presence of alterations of the urinary sediment (57/161; 35.4 %), mainly hematuria (38/161; 23.6 %). The histologic diagnosis was performed in 51 (89.4 %) out of 57 patient presenting with alterations of the urinary sediment, 14 (30.4 %) had IgA nephropathy, another patient presented with acute nephritis and azotemia not requiring dialytic treatment who subsiquently maintained a clinical picture of persistent microscopic hematuria. IgA nephropathy accounted for 9.3 % (15/161) of the total number of biopsies and 17 % (15/18) of all primary glomerular diseases. Clinical and histological findings were evaluated, as well as modifications of the renal function in all 15 patients presenting with IgA nephropathy, 14 of them presenting with creatinine clearance greater than 70 mL/min at the moment of the renal biopsy. It is concluted that the presence of arterial hypertension, proteinuria, and the histologic pattern of diffuse mesangial proliferation represent a bad prognosis in the course of the disease.

Keywords

BIOPSIA CON AGUJA, R, Medicine, BIOPSY. NEEDLE, GLOMERULONEFRITIS POR IgA, GLOMERULONEPHRITIS, IgA

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
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